Not 'just IBS'
What is IBS?
Irritable bowel syndrome (IBS) is a digestive problem thought to affect one in five people in the UK at some stage of their lives. The symptoms of IBS are very individual, but they include bloating, abdominal cramps and pain, excessive wind, diarrhoea with ‘urgency’ and constipation. People are often given a diagnosis and told it’s ‘just IBS’ but symptoms can affect stress levels, causing anxiety and embarrassment and significantly affect work and social life. Many sufferers are forced to take time off work when symptoms are unmanageable. But there is hope... the low FODMAP diet has a success rate of over 75% - improving and even eradicating symptoms, for good.
Management of IBS
If you’re suffering IBS symptoms you should initially discuss it with your GP. Tests should be arranged to exclude 'red flags' and coeliac disease. An enlightened GP may suggest trying the low FODMAP diet or they may suggest treating with drugs, but for some, drug therapy often exacerbates their symptoms. Traditionally, the advice has concentrated on the regularity of meals, adjusting fibre intake and reducing caffeine, fatty and spicy foods. For some patients, this advice may be sufficient, but for others their symptoms are more complex. Research in Australia has found a relationship between fermentable carbohydrates and IBS. In the UK, King’s College, London conducts its own research into what has become known as the ‘low FODMAP diet’. Studies have shown that over 75% of patients show improvement using the low FODMAP diet. NICE Clinical Guidelines (CG61, Feb 2015) and the British Dietetic Association recommend the low FODMAP diet as an effective treatment for IBS.
What are FODMAPs?
FODMAP stands for Fermentable Oligo-saccharides, Di-saccharides, Mono-saccharides And Polyols. In simple terms, the bacteria which line the gut, begin fermenting the FODMAPs in our diet, resulting in increased gas production, and therefore symptoms such as wind and bloating. An osmotic effect influences the amount of water in the large bowel, resulting in either diarrhoea or constipation or both. Reducing the intake of high FODMAP foods in the diet has been shown to improve the gut symptoms in most people with IBS.
The low FODMAP diet
Although this is a relatively new treatment for digestive problems and not that well known in the UK, it’s not a faddy diet, but an effective way of managing IBS by identifying trigger foods and minimising them in the diet. The low FODMAP diet is not a diet for life, it should be followed for up to eight weeks. When symptoms improve, food challenging can begin. This is a crucial part of the process, where finally patients are able to determine which foods cause their symptoms. If left to tackle this alone, patients can find the diet daunting, but a registered dietitian can help steer through the intricacies of the diet and support towards well-being.
A symptom-free future
Once you know which foods cause your symptoms, you can manage your IBS by minimising these in your diet. This puts you back in control again and you can get on with enjoying life!
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About Debra Thomas
I am a registered dietitian with the Health Care Professions Council, a member of the British Dietetic Association and a listed member of the BDA's Freelance Dietitians Group. I have over 17 years experience of advising on a range of therapeutic diets, but my area of expertise is the treatment of IBS using the low FODMAP diet.